Appointment Confirmation, Appointment Reminders - Doctor Dial Dr Dial Alliances

Membership has it benefits.

Doctor Dial offers sponsorship dollar contribuitions as well as the best membership benefit in the country. For more info, please contact us.

ASSOCIATION REGISTRATION

Association Name:
Contact Name:
Phone:	- -
Address:

City:
State:
Zip Code :

Email Address:
Create Password:

Association Code:	To be determined.
Total Members:
How did you hear about us


Do you have events you would like us to sponsor?
Yes No

What discount percent would you like to extend to your members?
15% 10% 5%

Would you like to use our service complementary for all your member's internal communications?
Yes No


I understand that after completing the association registration form, a Doctor Dial representative will contact me to further discuss the association program.